Accessing Health Services

The relationships we have with healthcare services are important in creating good health. However, many of us may experience problems in accessing supportive healthcare services.

Barriers for young women

Finding out you have HIV as a young woman or teenager can also feel really tough.

As young women and teenagers, we may find it particularly difficult seeing doctors and nurses who are also treating our parents, or other family members.

• Discussing sex, relationships and contraception with the same doctors we saw as children can feel really embarrassing. We may also be afraid of discussing these topics with male doctors. If this is the case, we can ask to change to another doctor. It’s our right to do this! Or we may prefer to go to a youth-friendly sexual health clinic instead.
• Deep anxieties around breaches of confidentiality, especially to family members, may also stop young people accessing key healthcare services.^[i]This is especially true for young women and teenagers who expect to receive a phone call or email from the doctor concerning the results. We can ask to have any information sent to us personally to a mobile phone, if we have one, so that we can delete it or keep our phones locked with a security code. Alternatively, we can get the clinic to keep any information until the next appointment.
• Knowing where to find the right healthcare for our situation can be difficult when we have not needed healthcare before. Our specialist HIV nurse can talk us through the different options.

Barriers for migrants

Some of us women in Europe may find further difficulties because we are migrants (with or without papers). Many of us face barriers unique to our situation.

• We may not be familiar with the system, have language problems, or we may fear deportation.^[ii]
• In many European countries, migrants without papers do not have access to healthcare.^[iii]
• Some of us may avoid services because of concerns that we will face other prejudices, for example prejudice against drug use, sex work or against those who have spent time in prison.^[iv]
• We may sometimes experience prejudice because staff in hospitals and clinics have not received training around HIV.
• For some of us, as migrants it can be difficult to ask a doctor too many questions, or to discuss our decisions, because we may come from cultures where doctors are figures of authority and we aren’t meant to ask them questions. In Europe however, our doctors are meant to be there to help. We should feel free to ask them questions.

Barriers for health workers with HIV

The healthcare and other caretaking professions employ large numbers of women. It stands to reason that some women health workers are HIV positive. For those of us who may work in healthcare, although being openly HIV positive in the work place could be of huge benefit to all our healthcare services, there are still we must face.

• We may fear that if our HIV status is revealed, it will affect employment possibilities and could even lead to being dismissed.^[v],[vi]
• We may also fear prejudice from employers or colleagues, or being sued by patients who learn of our HIV status.

Many aspects of healthcare carry no risk of HIV transmission whatsoever. Openly supportive healthcare settings would have much to teach other settings and sectors.Moreover, knowledge of our presence in the healthcare system would give a hugely positive message to people living with HIV in our care.

^[i] Silvia Petretti. Personal communications with Positively UK youth group members at poster presentation during AIDS 2010. Mind the gap: between paediatric and adult HIV services, WEPE0625.

^[ii] Cairns, Gus. UKCAB. Patients’ attitudes to HIV testing. Available athttp://www.bhiva.org/101201_GusCairns.aspx. Accessed 21 April 2011.

^[iii] Romero-Ortuño, Román. Access to health care for illegal immigrants in the EU: should we be concerned? European Journal of Health Law. 2004. 11:245-272.

^[iv] International Community of Women Living with HIV and AIDS. Silent Voices: A Community Engagement Project. 2006. Available at http://www.icw.org/files/silent%20voices%20full%20report%2006.doc. Accessed February 2011.

^[v] PozFem UK. Women, HIV and Sexual Health in the UK. Available at http://www.poz-fem-uk.org/docs/WomenHIVandSexualHealth.pdf. Accessed April 2011.

^[vi] Moroloake et al. Greater involvement of people living with HIV in health care. Journal of the International AIDS Society. 2009. 12:4.